NURSING THEORIES OVERVIEW Is an organized system of accepted
knowledge that is composed of
Key Points : concepts, propositions, definitions, and
assumptions intended to explain a set
1. PHENOMENON - An empirical data that can
of fact, event or phenomena.
be observed. In nursing , phenomena
can be client’s behavior (guarding CONCEPTS : is defined as an idea
behavior due to pain, disease process – formulated in the mind or an
gastric ulcer) experience perceived and observed.
(Ex. justice, love, war and disease);
2. HYPOTHESIS - A testable relationship
statements. PROPOSITION : Explains the
relationship of different concepts.
3. RESEARCH - Use of systematic methods to
study a phenomenon and create a (ex. Children who do not want to stay in
the hospital because of their fear of
general knowledge.
injections)
4. KNOWLEDGE - What is known in a particular
filed of discipline or study ; Facts and DEFINITION : Is composed of various
information or awareness or familiarity descriptions which convey a general
meaning and reduces the vagueness in
gained experience of a fact or situation.
understanding a set of concepts.
5. SCIENCE - From Latin scientia, meaning (Ex. Nursing as formulated by Peplau)
“knowledge”, refers to any systemaic
knowledge or practice in a discipline of ASSUMPTIONS : is a statement that
specifies the relationship or connection
study.
of factual concepts or phenomena.
6. DEDUCTION - A type of reasoning whe - rein (Ex. (The assumption of) All patients
general conclusions are made based who are not able to take good care of
from specific concepts. Cause and themselves need nurses)
effect. An example to nursing is to
reason that a lack of social support HOW OTHER AUTHORS DEFINE THEORY
(cause) results in hospital readmission
(effect). PARKER (2001) - “A theory, by traditional
7. INDUCTION - A type of reasoning that uses definition, is an organized, coherent set of
specific details to form a general concepts and their relationship to each other
conclusion. Example : Formulating that offers descriptions, explanations and
predictions about phenomena”
differential diagnoses of a patient.
POTTER (2004)- “A theory is a set of concepts,
definitions, relationships and assumptions that
What is a THEORY?
projects a systematic view of phenomena”
BLACKWELL (2005)- A reasoned proposed conception, labor and delivery, infancy,
explanation of an occurrence, or of something toodlerhood, preschool, school age,
that will occur or be produced, for which adolescence, adulthood and old age. It involves
absolute proof is lacking.” the promotion of health and prevention of
illness with collaboration with other health
Delaune and Ladner (2006) -An abstract team members for the curative, preventive, and
statement formulated to predict, explain or rehabilitative aspect of care, restoration of
describe the relationships among concepts, health, alleviation of suffering and when
constructs or events. recovery is not possible, towards a peaceful
death.”
WHAT IS NURSING?
1. ACCORDING TO AMERICAN WHAT IS NURSING THEORY?
NURSING ASSOCIATION
is the term given to the body of
(ANA):
“Nursing is the diagnosis and treatment of knowledge that is used to support
human responses to actual or potential health nursing practice.
problems”. Meleis (1991) defined nursing as “an
articulated and communicated
2. The International Council of
Nurses (2002) conceptualization of invented or
Defined nursing as….. discovered reality (central phenomena
and relationships) in or pertaining to
“….encompassing autonomous and nursing for the purpose of describing,
collaborative care of individuals of all ages, explaining, predicting, or prescribing
families, groups and communities, sick or well nursing care.”
and in all settings. Nursing also includes the
promotion of health, prevention of illness, and WHAT ARE NURSING PARADIGMS
the care of the ill, disabled, and dying people.
Are patterns or models to show a clear
Advocacy, promotion of a safe environment,
relationship among the existing
research, participation in shaping health policy
theoretical works in nursing. These
and in patient and health systems management,
major concepts in nursing are called
and education are also key nursing role.
metaparadigm
3. The Philippine Nursing Act of (Greek “meta” – with and “paradeigma
2002 (RA 9173) – pattern)
Defined nursing as…..
What is a Metaparadigm?
“….the initiation and/ or performance
of nursing services, singly or in collaboration A set of concepts and propositions that
with another, to individuals, families and sets forth the phenomena with which a
communities and in any health care settings. It discipline is concerned…
includes, but not limited to, nursing care during
Is the most general statement of a - may include patient’s family, friends,
discipline and functions as a framework and community.
in which the more restricted structures
of conceptual models develop (Miller- Example :
Nightingale defined person, as a recipient of
Keane Dictionary, 2003)
care ; (nothing more specific).
Metaparadigm, therefore is the most While, Virginia Henderson, defined person as a
abstract, global perspective of the biopsychosocial and spiritual being.
discipline. *Assessment of biopsychosocial and spiritual
components of a person.
The nursing knowledge continuum
starts with metaparadigms as the most (2) HEALTH – the concept of health is relative to
abstract – to practice or situation – the person and is defined according to the
specific theory as the most practical and patient’s perspective.
concrete form of nursing knowledge. - The holistic level of wellness that the
person experiences.
When we talk about the metaparadigm
of nursing, we are talking about the “What one person considers healthy, may be
areas that are the most general basis of considered unhealthy to another person. What
nursing practice, the elements of one person considers an acceptable quality of
nursing. life, may not be considered an unacceptable
quality of life to another person.”
For a theory to be considered a Nursing
Theory, the four metaparadigm in all its many aspects : physical, psychological,
concepts must be addressed. mental, intellectual, emotional and spiritual
components.
Extent to which they are addressed may
be different with the different theorists. EXAMPLE:
Nightingale defines nursing as “profession for
When reading different theories, some women with the goal to discover and use the
theorists will have the metaparadigm laws governing health in the service of
concepts very well defined; while others humanity. She believed that the goal of all
may only a couple of concepts well
nursing activity should promote client’s health.
defined ; others not very well fleshed
out. (3) ENVIRONMENT : This metaparadigm concept
focuses on the external and internal aspects of
life that influence the person.
Four (4) Metaparadigms Concepts of (i.e. Stress, genetics, adaptation >
Nursing: internal factors that influence on how we
(1) PERSON – this metaparadigm deal both external and internal
concept is the one receiving care ; environment.
recipient of care.
Example : Physical environment is emphasize by Theories can be the source of
Nightingale in her theory. She focused on hypotheses that can be tested for it to
ventilation, warmth, noise, light and cleanliness. be elaborated.
(4) NURSING : this nursing metaparadigm Theories contribute in enriching the
concept is related to the art and science of general body of knowledge through
nursing ; it consists of nursing actions or nursing the studies implemented to validate
interventions. them.
Think of this concept as WHAT NURSES Theories can be used by practitioner to
DO. direct and enhance their practice.
Don’t confuse it with the Theories must be consistent with other
metaparadigm concept of PERSON, a validated theories, laws and principles
nurse is a person but the metaparadigm but will leave open unanswered issues
concept of NURSING is different than that need to be tested.
that of a person.
The metaparadigm concept of
NURSING, includes :
What is Philosophy in Nursing?
The nurse applying professional
knowledge, procedural and technical Is the next knowledge level after
skills, and indirect and direct (hands-on) metaparadigm. It specifies the
definition of metaparadigm concepts in
patient care.
each of the conceptual models of
Example : nursing.
Nightingale emphasized that a nurse is
responsible in promoting well being of It sets forth the meaning of phenomena
clients by manipulating the through analysis, reasoning, and logical
environment. argument.
Examples of philosophical approaches
to Nursing : Nightingales Theory, Jean
CHARACTERISTICS OF A THEORY Watson - Theory of Transpersonal
Caring, Patricia Benner – Caring
Theories can correlate concepts in such
a way as to generate a different way of
looking at a certain fact of
phenomenon THEORY COMPONENTS
Theories must be logical in nature. Concepts : the building blocks of
theories, classify the phenomena
Theories should be simple but interest (Kaplan, 1964). Can either be
generally broad in nature. empirical or abstract data.
It enhances one’s capacity to literature, a ready –made map for the
understand a phenomena as it helps study.
define the meaning of a word.
CONCEPTUAL MODELS OR
Two types of concepts : FRAMEWORKS
1. Abstract concepts - are representations of an idea or body
of knowledge based on the own understanding
2. Concrete concepts or perception of a person or researcher on a
ABSTRACT CONCEPTS : are indirectly observed certain topic, phenomenon or theory. Structure
or intangible. It is independent of time and of concepts pulled together as a map for the
place. study.
Examples : Transport, vascular disease, loss of
relationship
CONCRETE CONCEPTS : are directly observed or
tangible.
Examples : strecher, wheelchair, hospital bed ;
stroke, Myocardial infarction (MI), peripheral
vascular diseases ; divorce, suicide.
Concepts can be used also in making conceptual
or an operational definition.
CONCEPTUAL DEFINITION : are
meaning of a word based on how a
certain theory or relevant literature
perceives it to be.
OPERATIONAL DEFINITIONS : are
meaning of a word based on the
method of how it was measured or how
the person come up with that
perception.
CONCEPTUAL MODELS AND THEORETICAL
MODELS.
THEORETICAL MODELS OR
FRAMEWORKS
- are highly established set of
concepts that are testable in the
(# TOPIC 3) GRAND THEORY
THE STRUCTURE AND ANALYSIS OF
Concepts that derive from a conceptual
NURSING KNOWLEDGE
model and propose a testable
STRUCTURE LEVELS OF NURSING KNOWLEDGE proposition that tests the major
premise of the model.
METAPARADIGM (Boykin and Schoenhofer, Meleis,
Pender, Leininger, Newman, Parse,
PHILOSOPHY Erickson, Tomlin, and Swain, Husted
and Husted)
CONCEPTUAL MODELS
NURSING THEORY
GRAND THEORY
Testable propositions from
THEORY
philosophies, conceptual models,
MIDDLE-RANGE THEORY grand theories, abstract nursing
theories, or theories from other
METAPARADIGM disciplines. Theories are les abstract
than grand theory and less specific
THE Broad Conceptual boundaries of
than middle-range theory.
the discipline of nursing : Human
beings, environment, health and (Boykin and Schoenhofer, Meleis,
nursing. Pender, Leininger, Newman, Parse,
Erickson, Tomlin, and Swain, Husted
PHILOSOPHY
and Husted)
Sets forth the meaning of nursing
MIDDLE-RANGE THEORY
phenomena through analysis,
reasoning, and logical presentation of Concepts most specific practice that
concepts and ideas. propose precise testable nursing
practice questions and include details
(Ex. Nightingale, Watson, Ray, Benner,
such as patient age group, family
Martinsen, Eriksson)
situation, health condition, location of
CONCEPTUAL MODELS the patient, and action.
Are sets of concepts that address (Ex: Mercer, Mishel, Reed, Wiener and
phenomena central to nursing in Dodd, Eakes, Burke and Hainsworth;
propositions that explain the Barker, Kolcaba, Beck, Swanson,
relationship among them. Ruland and Moore)
(Example : Levine, Rogers, Orem, King,
Neuman, Roy and Johnson)
ANALYSIS OF THEORY importance – guide critical reflection of each
theoretical work.
1. CLARITY
2. SIMPLICITY These broad criteria facilitate the analysis of
3. GENERALITY theoretical works, whether they are applied to
4. ACCESSIBILITY works at the level of philosophies, conceptual
5. IMPORTANCE
models, grand theories, theories or middle-
range theories.
ANALYSIS OF THEORY
CLARITY – speaks to the meaning of terms used,
and definitional consistency and structure speak
to the consistent structural form of terms in the
theory.
How clear is this theory?
SIMPLICITY – discuss the degree and call for
simple forms of theory. Comprehensive,
presented at a level of abstraction to provide
guidance and have few concepts to aid clarity.
How Simple is this theory?
GENERALITY – speaks to the scope of
application and the purpose within the theory.
The generality of a theoretical work varies by
abstract or concrete it is.
How General is this theory?
ACCESSIBILITY – addresses the extent to which
empiric indicators for the concepts can be
identified and to what extent purposes of the
theory can be attained.
How accessible is this theory?
IMPORTANCE – speaks of the outcome that
creates understanding which is important to
nursing.
How important is this theory?
The five criteria for the analysis of theory,
clarity, simplicity, generality, accessibility and
